Perinatal outcome of twin pregnancies after early transvaginal multifetal pregnancy reduction

Objective: To compare the pregnancy outcomes of twin pregnancies following early transvaginal multifetal pregnancy reduction (MPR) with nonreduced twin gestations.

Design: Prospective cohort study.

Setting: Two tertiary medical centers.

Patient(s): A cohort of 77 multiple pregnancies after reduction to twins and 78 dichorionic-diamniotic nonreduced twins.

Intervention(s): Early fetal reduction.

Main outcome measure(s): Pregnancy outcome.

Result(s): Triplet pregnancies reduced to twins (n = 55) and nonreduced twin pregnancies (n = 78) had comparable outcomes. The rates of preterm delivery ≤32 weeks (1.9% vs. 1.4%) and ≤34 weeks of gestation (15.1% vs. 19.2%) were similar among both groups. There was no difference in the mean gestational age (36.54 vs. 36.35 weeks) or mean birth weight (2,365 vs. 2,365 g) between the two groups. Similarly, there was no significant difference in the incidence of gestational diabetes (15.1% vs. 14.1%) and intrauterine growth retardation (IUGR; 1.9% vs. 9%) between the two groups. The incidence of gestational hypertension was higher in the study group (24.5% vs. 9%), but it was not associated with an increased risk for prematurity or IUGR.

Conclusion: The perinatal outcome of twin pregnancies after early transvaginal fetal reduction from triplets seems to be comparable to the outcome of nonreduced twin pregnancies.